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Wisconsin Department of Safety&Professional Services .// ^ ORIGINAL Page 1 p{ 9 <br /> Division of Industry Services - <br /> .�s�s SOIL V LUA ION REPORT <br /> In accordance with SPS 385,Wis,Adm.Code County n u j � CC <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must include, p Yv <br /> but not limited to vertical and horizontal reference point(BM),direction and percent slope, Parcel I.D. <br /> scale or dimensions,north arrow,and location and distance to nearest road. 74y, t'� 353RO <br /> Please print all information. Reviewed by Date p <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s. 15.04(1 xm)). I o Z <br /> Property Owner t � ,�C K/y/ Property Location <br /> At:-L-E ( <br /> r1Q --To VF N� Govt.Lot g r % S Zr7 T 3-7 N R W <br /> Property Owner's Mailing Address Site Address qr CSM and Lot#: <br /> 20q106C T Z- C 5,4-VL E 1 <br /> City,State,Zip Phone Number ❑City ❑Village 0 Town Nearest Road <br /> Lae`K t tl1 5-'tg5 5 (71s ) 553- 8 I TRIADS -7 <br /> NewConstnrction Use, Residential/Numberof Looms �` Cade derived designflow rateGPD R <br /> Replacement ❑Public or commercial-Describe: Flood Plan elevation d applicable_�_ft. <br /> Parent material SAADY <br /> General comments and recommendations: COAJ(fCV T/D/t� 11V-C-10il U Al� D.5 - FZ F�� !7 S <br /> ❑Baring <br /> Boring# Pii Ground surface elev5f.7O ft. Depth to limiting factor 6 in./elevIV7 ft. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 <br /> In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. "Eff#1 'Eff#2 <br /> 1 0411 .5Y 33 1.5 1 sbK ing 1 C5 zqU 6.7 1•4, <br /> 2- Y —" S Omm/ -- 4.7 t. 4 <br /> �Nv2 Gdd� <br /> []Boring <br /> Z Boring# Ground surface elev.9L ZO ft. Depth to limiting factorff—in./elev'EaN- <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 <br /> In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. "Eff#1 'Eff#2 <br /> -11 75Y 3 /e4w m r CS D 5 /.D <br /> ?1 -75 f5 1 .S 1.6 <br /> some 2 <br /> CST Name(Please Print) Signatur 1 CST Number <br /> MARY JO HUPPERT(Hollister's Sal Testing&De ign) l 224832 <br /> Address Date Evaluation Conducted Telephone Number <br /> 25720_Firefly Lane,Webster,WI 54893 / - pP___ __ __ __I <br /> 'Effluent#1=BOD>30 5 220 mg/L and TSS>30 s 150 mg1L 'Effluent#2=BOD,s 30 mg/L and TSS s 30 mg/L <br /> SBD-8330(R03/22) <br />